Family of 3 Grouping Mix Up, Help

[yorkriver1]

Last night I did an online Marketplace app for a family of 3. Husband, wife, 21 YO daughter.

The selection of plans said I could make groups with the 3 people. I said to make it one. I recall some questions here about putting folks into groups, but don't recall anything like this situation.

Even on plans with embedded deductibles, the plans now show with one group deductible of $12,000, $12,700, $11,000, etc. No individual, then group. They want a bronze plan.

Never saw this happen before.

Will call Marketplace to fix if I can't back up and redo, or would I have to do a new app....

Anyone know what to do? I could write them individually, but would have to change from group of one.

 

[cadylou]

Call the marketplace? Today??? good luck . . . .

 

[Quotebroker]

Another eligibility question:


60 year old woman eligible for the extension is having trouble filling out her application. She's technically married, but has been legally separated for many years and has no association with her former husband. She files taxes married filing separately. Is there a way to get this woman qualified for subsidies or does her marital status and unwillingness to file jointly leave her having to pay full price?

 

[RayNY]

File joint, get divorced, or don't get a subsidy.

There is no way to bypass the law or create a special exception for the client's convenience. She really does have to follow the rules.

 

[Ann H]

I've said this on several threads, and I don't think it's getting through.

It is not true that you are limited to "married joint", if you are married.

I know that's what it said on the CMS training last year, but that is not what it says in the regs, and not what the IRS is saying.

The issue is that you cannot file "married separate", if you are married.

You can file "Head of Household with Qualifying Dependent" (HOH) if you are married.

You can also file HOH if you have suffered domestic violence or if your spouse is missing, etc. In some domestic abuse situations, the return is technically filed as "married separate", but is considered a "married joint" return under the rules for the subsidy.

But you CANNOT file married separate otherwise.

I've linked to the IRS documentation before, but I'll do it again. The Premium Tax Credit

Eligibility
In general, you may be eligible for the credit if you meet all of the following:
buy health insurance through the Marketplace;
* are ineligible for coverage through an employer or government plan;
* are within certain income limits;
* do not file a Married Filing Separately tax return (unless you meet the criteria in Notice 2014-23, which allows certain victims of domestic abuse to claim the premium tax credit using the Married Filing Separately filing status for the 2014 calendar year); and
* cannot be claimed as a dependent by another person.

Filing Status
If you file your tax return using the filing status Single, Married Filing Jointly, Head of Household (including married individuals who qualify to use the Head of Household status) or Qualifying Widow/Widower, you may be eligible for the premium tax credit if you meet the other criteria. If you are married and you file your tax return using the filing status Married Filing Separately, you will not be eligible for the premium tax credit unless you meet the criteria in Notice 2014-23, which allows certain victims of domestic abuse to claim the premium tax credit using the Married Filing Separately filing status for the 2014 calendar year.​

 

[RayNY]

Thanks Ann!
If knowledge was power, we could run a small city off of you. I'll be sure to include the HOH/Single exceptions you mentioned moving forward.

To cite the relevant clause from Notice 2014-23(the exception you mentioned, which appears to apply in this case): "For calendar year 2014, a married taxpayer will satisfy the joint filing requirement of § 36B(c)(1)(C) if the taxpayer files a 2014 tax return using a filing status of married filing separately and the taxpayer (i) is living apart from the individual's spouse at the time the taxpayer files his or her tax return, (ii) is unable to file a joint return because the taxpayer is a victim of domestic abuse, and (iii) indicates on his or her 2014 income tax return in accordance with the relevant instructions that the taxpayer meets the criteria under (i) and (ii). The proposed regulations will incorporate this rule for 2014. "

I guess she gets to follow a rule I was unaware of. Apologies for the prior misinformation. This does appear to be "timebombed" to 2014 renewals, next year is a new story.

 

[Quotebroker]

Thanks all for the input. You've been helpful

 

[Ann H]

Thanks Ann!
If knowledge was power, we could run a small city off of you. I'll be sure to include the HOH/Single exceptions you mentioned moving forward.

To cite the relevant clause from Notice 2014-23(the exception you mentioned, which appears to apply in this case): "For calendar year 2014, a married taxpayer will satisfy the joint filing requirement of § 36B(c)(1)(C) if the taxpayer files a 2014 tax return using a filing status of married filing separately and the taxpayer (i) is living apart from the individual's spouse at the time the taxpayer files his or her tax return, (ii) is unable to file a joint return because the taxpayer is a victim of domestic abuse, and (iii) indicates on his or her 2014 income tax return in accordance with the relevant instructions that the taxpayer meets the criteria under (i) and (ii). The proposed regulations will incorporate this rule for 2014. "

I guess she gets to follow a rule I was unaware of. Apologies for the prior misinformation. This does appear to be "timebombed" to 2014 renewals, next year is a new story.

Remember, that the clause you quoted above is for domestic abuse situations. They have to meet all of the qualifications of the rule written above, not just the "living apart" portion. So, this isn't just for any ole' couple that is living apart.

Also, remember that a married couple can live apart for the last 6 months of the calendar year, and one of them could still potentially qualify to file "Head of Household with Qualifying Dependent". In that way they could potentially qualify for a subsidy without filing "married joint". Really, an accountant should make the determination of whether or not they can file Head of Household.

 

[AllenChicago]

Has anyone ever answered "NO" to the marketplace question, "Will You and Your Spouse File a Joint Return This Year?" If so, are you referred to the relevant IRS rules, to an accountant, or simply denied an APTC?

 

[Quotebroker]

Has anyone ever answered "NO" to the marketplace question, "Will You and Your Spouse File a Joint Return This Year?" If so, are you referred to the relevant IRS rules, to an accountant, or simply denied an APTC?

On our state-based exchange, there is a pop-up that says "you must file jointly to be eligible for APTC" which from this thread we know is incorrect.